How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,122 to $8,511Professionalmedian $1,514 · 10th to 90th $813 to $2,399
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,412.54 Median $2,818.38 Typical High $6,760.83 | Facility | None | $1,412.54 | $2,818.38 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,412.54 Typical High $1,412.54 | Professional | None | $758.58 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,630.78 Typical High $4,265.80 | Facility | None | $645.65 | $3,630.78 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,398.83 | Professional | None | $851.14 | $1,778.28 | $2,398.83 |
Hally Health Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,412.54 | Professional | None | $724.44 | $1,071.52 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $2,238.72 Typical High $9,772.37 | Facility | None | $1,000.00 | $2,238.72 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $1,698.24 Typical High $6,165.95 | Professional | None | $891.25 | $1,698.24 | $6,165.95 |
Midlands Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,238.72 | Professional | None | $1,778.28 | $1,778.28 | $2,238.72 |
Midlands Setting Facility Modifier None Typical Low $1,584.89 Median $3,548.13 Typical High $4,265.80 | Facility | None | $1,584.89 | $3,548.13 | $4,265.80 |
Midlands Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Oscar Health Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Oscar Health Setting Professional Modifier None Typical Low $707.95 Median $1,318.26 Typical High $1,621.81 | Professional | None | $707.95 | $1,318.26 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $10,964.78 | Facility | None | $1,258.93 | $3,630.78 | $10,964.78 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,202.26 Typical High $2,238.72 | Professional | None | $812.83 | $1,202.26 | $2,238.72 |
Wellmark Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,513.56 | $1,513.56 | $1,778.28 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $426.58 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $169.82 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $630.96 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $125.89 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $85.11 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $588.84 | $1,000.00 | $1,000.00 |
Where Iowa sits
The same service costs 5.4 times more in Alaska than in South Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
AK $8,807SC $1,633
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.